From the Guidelines
Effectiveness of Flomax (Tamsulosin) for Women with Ureteral Stones
Tamsulosin (Flomax) is likely effective for women with ureteral stones measuring 4 millimeters in diameter as a medical expulsive therapy to facilitate stone passage.
- The recommended dose is 0.4mg orally once daily, taken for a duration of 4-6 weeks 1.
- This alpha-blocker has been shown to increase the likelihood of spontaneous stone passage, although its efficacy in women is less established compared to men, and individual patient response may vary 1.
- Alpha-blockers, such as Tamsulosin, are the preferred agents for medical expulsive therapy (MET) due to their ability to facilitate ureteral stone passage by relaxing ureteral smooth muscle 1.
- The use of Tamsulosin for MET is supported by guidelines, including those from the American Urological Association (AUA) and the Endourological Society, which recommend its use for distal ureteral stones 1.
- While the evidence is largely based on studies in men, the principles of medical expulsive therapy can be applied to women, although individual results may vary 1.
From the Research
Efficacy of Flomax (Tamsulosin) for Women with Ureteral Stones
- The efficacy of Flomax (Tamsulosin) for women with ureteral stones measuring 4 millimeters in diameter is not directly addressed in the provided studies, as most studies focus on the general population or do not specify the gender of the participants.
- However, the study 2 found that tamsulosin did not significantly increase the stone passage rate compared with placebo for stones smaller than 9 mm, which may include stones of 4 mm in diameter.
- Another study 3 found that tamsulosin significantly improves stone passage in patients with larger stones (5 to 10 mm), but the effect of tamsulosin is diminished in those with smaller stones (<4 to 5 mm).
- A systematic review and meta-analysis 4 found that tamsulosin is effective and relatively safe in patients with ureteral stones as a medical expulsive therapy to facilitate stone passage, but the benefit is more significant for stones greater than 5 mm.
Stone Size and Tamsulosin Efficacy
- The study 5 included patients with distal ureteral stones (4-10 mm) and found that tamsulosin facilitated the spontaneous passage of distal ureteral stones < 10 mm in size in an effective manner.
- The study 6 included patients with stone size ≥ 4 mm in the distal 1/3 of the ureter and found that tamsulosin increased the stone expulsion rate and reduced the expulsion time.
- The study 3 found that tamsulosin is more effective for larger stones (5 to 10 mm) than for smaller stones (<4 to 5 mm).
Gender and Tamsulosin Efficacy
- None of the provided studies specifically address the efficacy of tamsulosin for women with ureteral stones measuring 4 millimeters in diameter.
- The study 2 included 139 female participants, but the results are not stratified by gender.
- More research is needed to determine the efficacy of tamsulosin for women with ureteral stones, particularly for stones of 4 mm in diameter 5, 4, 6, 2, 3.